Résultats de re-traitement pipeline v2 sur 261 dossiers. Co-Authored-By: Claude Opus 4.6 <noreply@anthropic.com>
230 lines
7.7 KiB
JSON
230 lines
7.7 KiB
JSON
{
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"source_file": "BACTERIO 23099769.pdf",
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"document_type": "crh",
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"sejour": {},
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"diagnostic_principal": {
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"texte": "Infection urinaire",
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"cim10_suggestion": "N39.0",
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"cim10_confidence": "high",
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"cim10_final": "N39.0",
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"cim10_decision": {
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"action": "PROMOTE_DP",
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"final_code": "N39.0",
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"reason": "DAS promu en DP (score (2, 3, 4))",
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"needs_info": [],
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"applied_rules": [
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"RULE-DAS-TO-DP"
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]
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},
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"sources_rag": [],
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"preuves_cliniques": [],
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"source": "regex",
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"source_page": 1,
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"source_excerpt": "...n selon\nles recommandations du CA-SFM 2022\nConclusion\nAbsence d'arguments microbiologiques pour une infection urinaire\nCompte-rendu : Complet (1) analyse référencée sous\nACCREDITATION COFRAC Page 1/2\nValidé et diffusé..."
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},
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"dp_selection": {
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"chosen_index": 0,
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"chosen_term": "Infection urinaire",
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"chosen_code": "N39.0",
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"verdict": "CONFIRMED",
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"evidence": [
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"Score 5.0 — source: regex (section forte)",
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"Conclusion: «Absence d'arguments microbiologiques pour une infection urinaire\nCompte-rendu : Complet (1) analyse référencée sous\nACCREDITATION COFRAC Page 1/2\nValidé et diffusé sous la responsabilité du biologiste : Dr. Anne Christine JAOUEN N° 8-3188\nP»"
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],
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"reason": "Candidat unique",
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"candidates": [
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{
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"index": 0,
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"term": "Infection urinaire",
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"code": "N39.0",
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"source": "regex",
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"is_comorbidity_like": false,
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"is_symptom_like": false,
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"is_act_only": false,
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"section_strength": 3,
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"num_occurrences": 1,
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"score": 5.0,
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"score_details": {
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"section": 3,
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"confidence": 0,
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"diag_section_bonus": 2
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}
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}
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],
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"debug_scores": {
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"top1": 5.0
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}
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},
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"dp_crh_only": {
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"chosen_index": 0,
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"chosen_term": "Infection urinaire",
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"chosen_code": "N39.0",
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"verdict": "CONFIRMED",
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"evidence": [
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"Score 5.0 — source: regex (section forte)",
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"Conclusion: «Absence d'arguments microbiologiques pour une infection urinaire\nCompte-rendu : Complet (1) analyse référencée sous\nACCREDITATION COFRAC Page 1/2\nValidé et diffusé sous la responsabilité du biologiste : Dr. Anne Christine JAOUEN N° 8-3188\nP»"
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],
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"reason": "Candidat unique",
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"candidates": [
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{
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"index": 0,
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"term": "Infection urinaire",
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"code": "N39.0",
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"source": "regex",
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"is_comorbidity_like": false,
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"is_symptom_like": false,
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"is_act_only": false,
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"section_strength": 3,
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"num_occurrences": 1,
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"score": 5.0,
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"score_details": {
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"section": 3,
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"confidence": 0,
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"diag_section_bonus": 2
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}
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}
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],
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"debug_scores": {
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"top1": 5.0
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}
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},
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"dp_final": {
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"chosen_index": 0,
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"chosen_term": "Infection urinaire",
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"chosen_code": "N39.0",
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"verdict": "CONFIRMED",
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"evidence": [
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"Score 5.0 — source: regex (section forte)",
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"Conclusion: «Absence d'arguments microbiologiques pour une infection urinaire\nCompte-rendu : Complet (1) analyse référencée sous\nACCREDITATION COFRAC Page 1/2\nValidé et diffusé sous la responsabilité du biologiste : Dr. Anne Christine JAOUEN N° 8-3188\nP»"
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],
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"reason": "Candidat unique",
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"candidates": [
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{
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"index": 0,
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"term": "Infection urinaire",
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"code": "N39.0",
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"source": "regex",
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"is_comorbidity_like": false,
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"is_symptom_like": false,
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"is_act_only": false,
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"section_strength": 3,
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"num_occurrences": 1,
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"score": 5.0,
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"score_details": {
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"section": 3,
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"confidence": 0,
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"diag_section_bonus": 2
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}
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}
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],
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"debug_scores": {
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"top1": 5.0
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}
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},
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"quality_flags": {
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"rag_status": "error",
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"crh_only_mode": true
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},
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"diagnostics_associes": [],
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"actes_ccam": [],
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"antecedents": [],
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"traitements_sortie": [],
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"biologie_cle": [
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{
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"test": "Leucocytes",
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"valeur": "16",
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"valeur_num": 16.0,
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"anomalie": true,
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"quality": "ok",
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"source_page": 1,
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"source_excerpt": "...ie ci-dessous rendu(s) sous accréditation (1) sauf mention contraire\nECBU - Milieu de jet\nCytologie\nLeucocytes 16 /µL <10\nAutomate Iris IQ 200 Select (Beckman-Coulter)\nHématies 20 /µL <10\nAutomate Iris IQ 200 S..."
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}
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],
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"biologie_discarded": [],
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"imagerie": [],
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"complications": [
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{
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"texte": "Infection",
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"source_page": 1,
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"source_excerpt": "...n selon\nles recommandations du CA-SFM 2022\nConclusion\nAbsence d'arguments microbiologiques pour une infection urinaire\nCompte-rendu : Complet (1) analyse référencée sous\nACCREDITATION COFRAC Page 1/2\nValidé et..."
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}
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],
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"alertes_codage": [
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"QUALITE DEGRADEE : erreur RAG — codage sans référentiels",
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"CMA niveau 2 : 'Infection urinaire' (N39.0) — sévérité non_evalue",
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"QC: DAS N39.0 (Infection urinaire) à reconsidérer — ABSENCE DE PREUVE CLINIQUE : Le dossier mentionne une 'complication : infection' de manière générique, SANS spécification du site infectieux. N39.0 (infection urinaire) est un codage par HYPOTHÈSE non justifié. La leucocytose (16 [N:4-10]) est un marqueur non-spécifique d'infection. Aucun élément clinique, biologique ciblé (ECBU, culture urinaire) ou symptomatique (dysurie, pollakiurie) ne documente une infection urinaire.",
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"QC: ⚠️ CODAGE INFONDÉ : Infection urinaire codée sans justification probante",
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"QC: ⚠️ MANQUE DE SPÉCIFICITÉ : L'infection est mentionnée comme 'complication' mais le site n'est pas identifié (urinaire ? pulmonaire ? autre ?)",
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"QC: ⚠️ RECOMMANDATION : Soit coder une infection non-spécifiée (R50.9 ou A49.9 selon contexte), soit demander clarification clinique au prescripteur sur le site exact de l'infection avant codage",
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"QC: ⚠️ QUALITÉ PMSI : Risque de codage abusif = impact financier et statistique injustifié",
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"RULE-DAS-TO-DP: DP absent → DAS N39.0 (Infection urinaire) promu en DP",
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"DECISIONS[PDF]: 1 ligne(s)",
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"DECISION: diagnostic_principal N39.0 promu en DP (RULE-DAS-TO-DP)"
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],
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"source_files": [],
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"ghm_estimation": {
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"cmd": "11",
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"cmd_libelle": "Affections du rein et des voies urinaires",
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"type_ghm": "M",
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"severite": 1,
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"ghm_approx": "11M??1",
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"cma_count": 0,
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"cms_count": 0,
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"alertes": []
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},
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"controles_cpam": [],
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"veto_report": {
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"verdict": "PASS",
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"score_contestabilite": 100,
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"issues": []
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},
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"completude": {
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"checks": [
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{
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"code": "N39.0",
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"libelle": "Infection urinaire",
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"type_diag": "DP",
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"items": [
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{
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"categorie": "biologie",
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"element": "ECBU",
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"statut": "absent",
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"importance": "obligatoire",
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"impact_cpam": "ECBU obligatoire pour documenter une infection urinaire"
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}
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],
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"score": 30,
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"verdict": "indefendable",
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"resume": "0/1 obligatoires"
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}
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],
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"score_global": 30,
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"verdict_global": "indefendable",
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"documents_presents": [
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"crh"
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],
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"documents_manquants": []
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},
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"processing_time_s": 8.62,
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"metrics": {
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"das_total": 0,
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"das_active": 0,
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"das_excluded": 0,
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"das_removed": 0,
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"das_ruled_out": 0,
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"das_no_code": 0,
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"actes_total": 0,
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"actes_with_code": 0,
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"dp_has_code": true
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},
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"rules_runtime": {
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"router_version": 1,
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"mode": "strict",
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"enabled_packs": [
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"decisions_core",
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"vetos_core"
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],
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"always_on_rules": [],
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"triggers_fired": []
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}
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} |